Australian-first psychedelic-assisted therapy trial for terminally ill patients shows improved quality of life

Michael Quinn's prostate cancer had spread throughout his body when he came across a newspaper call-out that would change the course of what remained of his life.

The newspaper was asking for people to take part in an Australian-first clinical trial investigating how psychedelics, combined with psychotherapy, could help alleviate the anguish often experienced by people who have a terminal illness.

Terror-stricken about the prospect of death, and suffering from bouts of panic and catatonic depression, Michael registered his interest.

His wife Pat Quinn said the results would ultimately be life-changing for her late husband.

"He felt that the program softened the edges of his edges and found a new path to dealing with this illness," she said.

"He still had some anxiety, obviously, and some frustrations, but he was much, much more calm."

Over the course of three-and-a-half years, researchers at St Vincent's Hospital in Melbourne have examined the use of synthetic psilocybin — the compound naturally found in "magic mushrooms" — in combination with psychotherapy for 35 people, including Michael, with advanced terminal illness.

The pool of patients was small, but the study's co-author, clinical psychologist Dr Margaret Ross said the results, published in the peer-reviewed medical journal General Hospital Psychiatry, were promising.

"We did see reductions in depression, anxiety, hopelessness, demoralisation — so we saw big reductions in psychological distress. But not only that, we also saw increases and improvement in quality of life," Dr Ross said.

"Beyond the metrics we saw people experiencing things like reconciliation and forgiveness in situations where there were fractured relationships in the past.

Therapy not a match for everyone: clinicians

As well as treating people with terminal cancer, the study was the first in the world to offer psilocybin-assisted therapy to patients with non-cancerous life-threatening conditions like motor neurone disease.

Participants in the trial took two doses, six to seven weeks apart.

Half the participants received a placebo for the first dose, while all participants received psilocybin for the second dose.

Patients then spent roughly seven hours in a calm, dark room listening to music.

Both Dr Ross and co-author, psychiatrist Justin Dwyer, were at their side, and sometimes hours would pass without anyone saying a word.

Each dose was preceded and followed by psychotherapy sessions.

Dr Dwyer said the accompanying psychotherapy was an essential part of the treatment, but noted the gruelling nature of the entire process could be challenging for some participants.

"The narrative about psychedelics is really problematic. I think they're presented as things which are going to cure mental illness, prevent suicide — they're presented as things which are going to transform really intractable states of suffering," he said.

"I have a real problem with that, a) because it's not true in the way it's presented, but b) because it sort of downplays the amount of work people have to do and the courage which is required to sort of do that work in a deep way."

The clinicians also caution that psychedelic-assisted therapy was not a match for certain people, including those with some psychiatric disorders, such as schizophrenia.

"If they struggle to tell the difference between emotions and physical sensations, if they've got a lot of really raw, unprocessed trauma that they're avoiding, I think potentially it could be a very harmful treatment," Dr Dwyer said.

But for others, Dr Ross said the therapy could help people face the end of their life.

"It's kind of like staring at the sun, you can't look at it for too long. It's so difficult and so terrifying for many to accept that they're not going to exist anymore," she said.

"So to kind of be able to sit with, and face and walk through and transform, this experience of terror in the face of the unbearable meant that people could, instead of living with this terror, this daily existence with these thudding reminders that their life was going to be coming to an end very shortly — they could actually go, no, I'm still alive."

Researchers push to deliver treatment more broadly

The clinicians are now trying to expand the research, which is largely still in its infancy.

For decades psychedelic therapy has been shunned by researchers and the medical community, weighed down by baggage from Richard Nixon's war on drugs as well as a lack of interest from pharmaceutical companies who do not stand to profit from non-patented treatments.

Australia's national medical regulator only approved the therapeutic use of some psychedelics to treat specific mental health conditions in 2023, making the country one of the first in the world to officially recognise psilocybin as a medicine.

Dr Ross said as a result, more work was needed to understand how to deliver this type of treatment more broadly and affordably, with the treatment currently requiring hours of clinician time.

"It's tens of thousands of dollars. We've seen it, you know, upwards of $26,000, which is just inaccessible for, you know, 95 per cent of the population," she said.

"We need to be looking at how we can roll this out in a more cost-effective, time-effective and accessible way."

Co-Director of Health and Policy at the University of Sydney's Brain and Mind Centre Ian Hickie said the results of the trial were encouraging, with other treatments for terminally ill patients historically failing to ease the anguish people can experience when they know they are about to die.

"The focus of the study is a really interesting one. It's a population that traditionally hasn't done well with a lot of the traditional approaches, which are often sedative medicines, slow forms of psychological care, ineffective forms of meditation, or mindfulness that really don't go to the level of distress that people are experiencing," he said.

But Professor Hickie noted he was cautious about "over-interpreting" the results of a small trial, emphasising the psychedelics could be harmful for certain people, and agreeing that more research needed to be done.

"There may be a window that's created to make psychological treatments more effective as a consequence of using psychedelic drugs," he said

"The psychedelics alone won't be the solution. What's the best combination? What opportunity is created and can you capitalise on that?"

Pat Quinn meets researchers who helped her husband face death

Dr Ross and Dr Dwyer's consulting rooms are a hidden retreat in the middle of busy Melbourne, largely unnoticed by those passing by.

As she enters the space, Pat Quinn reunites with the two clinicians who helped her husband face death.

Dr Ross offers Pat a hug and a cup of tea, while telling her they kept the sugar they bought especially for Michael when he would come in for his appointments.

"Marg and Justin, what they did for Michael I think was outstanding. The difference that it made and the difference that it made for me," she said.

She said Michael participated in the trial with the hope it would not only help him, but ultimately others too.

"It made a huge difference and I don't think he would have coped and I don't know that I would have coped either if he hadn't been through that process and I would hope that it could be expanded to help a lot of other people through it," she said.

"I know it's not a cure, but if it helps people to deal with what they're going through it's got to be beneficial.

"It meant a lot to me. It meant a lot to him. And he meant a lot to me."